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R Matorras

Publications and source records attributed to R Matorras.

At least 19 recordsLinked to original sources
PubMed2004

Influence of the time interval between embryo catheter loading and discharging on the success of IVF.

BACKGROUND: To ascertain the influence of the duration of the 'interval loading-discharging embryos' (ILDE) on the results of embryo transfer. METHODS: The population under study consisted of 450 consecutive fresh embryo transfers. ILDE was measured in all transfers. Pregnancy and implantation rates were analyzed. RESULTS: Conceptional cycles had a lower (mean +/- SD) ILDE than non conceptional cycles (53.5 +/- 43.6 s vs 63.7 +/- 49.3). When only easy transfers--defined as those not requiring cervical tenaculum--were considered, similar differences were observed. The following pregnancy rates were obtained according ILDE duration: 38.9% (ILDE < 30 s), 33.2% (ILDE 31-60), 31.6% (ILDE 61-120) and 19.1% (ILDE > 120) (P < 0.05). When only easy transfers were considered, similar results were obtained: 40.0%, 33.3%, 32.0% and 19.4%, respectively. Similar results were observed regarding implantation rates regarding the whole population (21.2%, 15.4%, 15.9% and 9.4%, respectively; P < 0.01) as well as when only easy transfers were considered. CONCLUSIONS: ILDE duration is a prognostic factor of pregnancy rate and of implantation rate in IVF. The longer the ILDE duration, the lower the pregnancy and implantation rates. The decrease in pregnancy and implantation rates is gradual until an ILDE of 120 s, and decreases sharply afterwards. It is recommended to speed up the embryo transfer process, wherever possible. ILDE > 120 s carries a poor prognosis and should, when possible, be avoided.

Adult↗
PubMed2002

Ultrasound-guided embryo transfer improves pregnancy rates and increases the frequency of easy transfers.

BACKGROUND: Recent reports have suggested that ultrasound (US) guidance during embryo transfer might improve pregnancy rates. METHODS: A prospective randomized (computer-generated random table) trial was performed to compare embryo transfer under abdominal US guidance (n = 255 women) with clinical touch embryo transfer (n = 260). RESULTS: The clinical pregnancy rate was 26.3% (67/255) in the US-guided transfer group compared with 18.1% (47/260) in the clinical touch transfer group (P < 0.05). The implantation rate was 11.1% (100/903) in the US group compared with 7.5% (66/884) in the clinical touch group (P < 0.05). US-guided transfer was associated with a decrease in the difficulty of the transfers: 97% of transfers were easy in the US-guided group compared with 81% in the clinical touch group (P < 0.05). CONCLUSIONS: US-guided embryo transfer increased pregnancy and implantation rates in IVF cycles, as well as the frequency of easy transfers. It is suggested that the decrease in cervical and uterine trauma can play a role in the increase in pregnancy rates associated with US-guided transfer. It is recommended that embryo transfer should be performed under US guidance.

Adult↗
PubMed2002

Ovarian stimulation in intrauterine insemination with donor sperm: a randomized study comparing clomiphene citrate in fixed protocol versus highly purified urinary FSH.

BACKGROUND: The study was conducted to compare the results of intrauterine donor insemination (DI) under ovarian stimulation with either clomiphene citrate (CC), in a fixed protocol, or FSH, with ovarian monitoring. METHODS: Forty-nine patients were randomized using a computer-generated list to receive highly purified urinary FSH (starting dose of 150 IU) and were subjected to periodic vaginal ultrasound and estradiol determinations. HCG was given when > or =2 follicles (> or =17 mm) were identified and estradiol reached >400 pg/ml. Intrauterine insemination (IUI) was performed 36 h later. The other 51 received CC on a fixed protocol (100 mg/day from the day 5-10 of the ovarian cycle) with HCG being administered on the day 12, and IUI performed 36 h later. Up to six IUI cycles were performed on all patients if pregnancy was not reached before. Women failing to conceive in the CC group underwent IUI with FSH. The main outcome measures were intrauterine gestational sac observed by transvaginal ultrasound, per cycle and per woman pregnancy rate (PR) and multiple PR. RESULTS: The per cycle PR was significantly higher in the FSH group, 14.4% (30/209) versus 6.1% (16/261), as well as the per woman PR, 61.2% (30/49) versus 31.4% (16/51). 12.5% (2/16) of pregnancies obtained in the CC group were multiple, compared with 20% (6/30) in the FSH group. There were no triplets or higher order pregnancies in CC versus two in FSH (6.7% of pregnancies). Patients failing to conceive with CC, who later underwent intrauterine DI with FSH, had similar results to the primary FSH group: 54.3% PR per patient (19/35) and 16.0% per cycle (19/118), with a multiple PR of 31.6% (6/19). The PR for women starting with CC cycles and, if pregnancy was not obtained, continuing with six FSH cycles, was 69.2%. CONCLUSIONS: The PR obtained with CC stimulation was approximately half that obtained with FSH. There was a trend to lower multiple PR with CC. It is recommended that each case should be considered on an individual basis and the treatment options discussed with patients. In our opinion, CC could be a reasonable approach for young women with good prognosis, whereas in the remaining cases FSH would be the preferable method.

Adult↗
PubMed2001

17beta-estradiol affects in vivo the low density lipoprotein composition, particle size, and oxidizability.

The aim of this study was to explore the possible modifications induced by 17beta-estradiol (E(2)) in vivo on low-density lipoprotein (LDL) lipid composition, particle size, and oxidizability. For this purpose, women were recruited from an in vitro fertilization program, ranging their plasma E(2) levels from less than 12 pg/ml to more than 2000 pg/ml at the end of the treatment. The LDL lipid constituents were analyzed by thin layer chromatography and image analysis, and the LDL diameter was calculated from the lipid data. The results showed that high plasma E(2) levels were associated with smaller LDL particles, with lower amounts of free and esterified cholesterol and an increased relative content of alpha-tocopherol. The hormonal treatment produced a remodelation of the LDL acyl composition, rendering a lipoprotein enriched in saturated fatty acids, with a poorer polyunsaturated fatty acid content. These alterations in the physicochemical properties of LDL paralleled changes in the susceptibility of LDL to in vitro oxidation induced by both Cu(2+) and the peroxyl radical generator, 2,2'-azobis (2-amidinopropane), these changes being mainly reflected in a reduced maximum oxidation rate. The in vivo changes in the physicochemical properties of LDL induced by E(2) could explain some of the antiatherogenic actions of estrogens.

Adult↗
PubMed2001

Women who are not exposed to spermatozoa and infertile women have similar rates of stage I endometriosis.

OBJECTIVE: To compare the prevalence of endometriosis and its different stages in infertile women and women not exposed to spermatozoa. DESIGN: Prospective study. SETTING: Artificial insemination donor program at a university hospital. PATIENT(S): One hundred fifty women unable to conceive because they had not been exposed to spermatozoa (134 with azoospermic partner, 10 with an HIV-positive partner, and 6 without a male partner). Controls were 750 women in infertile couples in which the male partner had normal sperm. INTERVENTION(S): Laparoscopy was systematically performed in a blinded manner in both groups as part of the infertility work-up. MAIN OUTCOME MEASURE(S): Diagnosis of endometriosis. RESULT(S): In unexposed women and controls, the prevalence of endometriosis was similar (32% and 34.5%). Rates of stage I disease were also similar in both groups (26% and 19.3%). There was a significant trend toward higher stages of endometriosis in infertile women (stage II disease, 3.3% vs. 5.7%; stage III disease, 1.3% vs. 3.1%; stage IV disease, 1.3% vs. 6.4%). Endometriosis was not associated with the few demographic characteristics that differed between groups. CONCLUSION(S): From an epidemiologic point of view, stage I endometriosis is not more common in infertile women than in unselected women. However, stage II to IV endometriosis was more frequent in infertile women. Whereas a relation between stage I endometriosis and infertility seems unlikely, the relation between stages II to IV endometriosis and infertility seems possible.

Adult↗
PubMed2001

Increased tissue concentrations of arachidonic acid in umbilical artery and placenta in fetal growth retardation.

OBJECTIVE: To compare the fatty acid phospholipid composition of the umbilical artery and the placenta in cases of fetal growth retardation (FGR) and of normal growth, as well as in symmetric and asymmetric FGR. DESIGN: Case-control study. SETTING: University hospital. POPULATION: Thirty-nine FGR cases (12 asymmetric, 27 symmetric) and 78 cases with normal growth. MAIN OUTCOME MEASURES: Thin layer gas-liquid capillary chromatography of phospholipid fatty acids in umbilical artery and placental cotyledons. Newborns were classified as FGR if their weight was under the 10th percentile for our center. FGR was defined as symmetric if the ponderal index was >2.32, and as asymmetric if it was <2.32. RESULTS: In FGR, arachidonic acid was significantly increased both in placenta (24.05%+/-2.78 vs 22.46%+/-2.93) and in umbilical artery (16.76%+/-2.40 vs 15.58%+/-3.67). Indeed this increase was significantly higher in asymmetric than in symmetric FGR (25.70+/-2.32 vs 23.32+/-2.68 in placenta and 18.06+/-1.46 vs 16.14 +/-2.53 in umbilical artery). On the other hand, in the placenta there were a number of differences in the metabolic ratios analyzed when comparing symmetric and asymmetric FGR, indicating a lower DHA availability and a higher n-6 fatty acid elongation and desaturation in asymmetric FGR. CONCLUSION: FGR is characterized by an increase in arachidonic acid both in the placenta and umbilical artery phospolipids, probably reflecting a different mobilization from tissue stores. It is speculated that the different arterial composition could be partially responsible for the increased cardiovascular risk of FGR in adulthood. On the other hand the metabolic status of the placenta concerning polyunsaturated fatty acids was very different in symmetric and asymmetric FGR, suggesting a different pathogenesis.

Adult↗
PubMed2001

Longitudinal study of fatty acids in plasma and erythrocyte phospholipids during pregnancy.

AIM: To assess the modifications of the main fatty acids (FA) in plasma and red blood cells during pregnancy. METHODS: A longitudinal study of 36 normal pregnant women was carried out with 3 cut-off points: first trimester, second trimester and third trimester. 14 FA in plasma and erythrocyte phospholipids were measured using capillary gas chromatography. Measurements were expressed in percentages and in absolute values. RESULTS: In plasma there was a significant increase in the proportion of saturated FA and a decrease in the proportion of long chain polyunsaturated fatty acids (PUFA) both in the omega 6 (omega 6) and omega 3 (omega 3) series. On the other hand, in erythrocyte phospholipids there was a decrease in the proportion of eicosapentaenoic acid and an increase in that of docosahexaenoic acid. In the omega 6 series, dihomo-gamma-linolenic acid increased, whereas the omega 6 docosapentaenoic acid decreased. CONCLUSION: There was a significant decrease in the proportion of omega 3 PUFA in plasma from the first to the third trimester. Thus, it is suggested that the omega 3 PUFA intake during pregnancy should be increased in the last trimester.

8,11,14-Eicosatrienoic Acid↗
PubMed2000

Severe bradycardia and bradypnea following vaginal oocyte retrieval: a possible toxic effect of paracervical mepivacaine.

We report a case of a patient with a history of heart conduction disease, symptom-free and without treatment in the last years, who experienced a severe cardiac complication associated with in vitro fertilization (IVF) with vaginal oocyte retrieval (VOR). Eighty-five minutes after the VOR a severe bradycardia and bradypnea occurred, requiring an emergency application of a pacemaker. Presumably the condition occurred because of a toxic effect of the 400 mg of mepivacaine administered paracervically. It is concluded that in the paracervical anesthesia in the IVF cycles the therapeutic range should be scrupulously followed in patients with heart condition.

Adult↗
PubMed2000

Uterine side effects of treatment with tamoxifen.

OBJECTIVE: To assess a causal the relationship between endometrial lesions and tamoxifen therapy in patients with breast cancer. DESIGN: Prospective longitudinal study and cross-sectional study. SETTING: Cancer prevention unit at Basurto Hospital, Bilbao. POPULATION AND METHODS: Three populations of breast cancer were studied: 43 before the beginning of tamoxifen; 78 after 5-72 months of tamoxifen, and 34 before tamoxifen and after 12-24 months of tamoxifen treatment (PAIRED GROUP). All of them were systematically studied with CO(2) diagnostic hysteroscopy and endometrial biopsy by the same clinician. RESULTS: Before tamoxifen, the following endometrial lesions were detected: endometrial polyps 9.3%; endometrial cysts 16.3%; synechiae 11.6%. In the paired group the ingestion of tamoxifen shows a direct causal effect with a significant increase in endometrial polyps (11.8% vs. 29.4%; OR=13; CI=7.9-18.1), in endometrial cysts (17.7% vs. 55.9%; OR=7.5; CI=5. 9-9.1) and in synechiae (14.7% vs. 35.5%; OR=8; CI=4.7-11.3). In the group under tamoxifen for 5-72 months, one endometrial carcinoma was detected. CONCLUSIONS: Breast cancer patients have a number of endometrial lesions before undergoing any hormonal therapy. Tamoxifen significantly increased benign endometrial lesions, usually after less than one year of treatment. No cases of endometrial carcinoma was found in our series of 34 patients with 1-2 years of tamoxifen treatment, and 1/78 in patients with 5-72 months of tamoxifen.

Biopsy↗
PubMed2000

Recombinant human FSH versus highly purified urinary FSH: a randomized study in intrauterine insemination with husbands' spermatozoa.

A randomized trial was carried out comparing recombinant FSH (rFSH) and highly purified urinary FSH (uFSH) in intrauterine insemination (IUI) with husbands' spermatozoa. A total of 45 women received rFSH (139 cycles), while 46 women received uFSH (155 cycles). The starting dose was 150 IU/day s.c., beginning on the second day, and on days 6-7 the dose was adjusted according to ovarian response, assessed by vaginal ultrasound and plasma oestradiol concentration. The pregnancy rate according to the intention to treat was 57.8% in rFSH versus 52.2% in uFSH, the corrected pregnancy rates 56.8% and 52.2%, and the cumulative pregnancy rates 69.6% and 61.0%, but the differences were not statistically significant. The per cycle pregnancy rate was 18.12% in rFSH and 15.48% in u-FSH, also not statistically significant. In the rFSH group, the consumption of FSH ampoules per cycle was significantly lower (19.20 +/- 7.02 versus 23. 80 +/- 10.78; P < 0.0001). The ratio of oestradiol/FSH ampoules was significantly higher in rFSH (56.45 +/- 31.26 versus 46.41 +/- 29. 25; P < 0.001). These data indicate that, in IUI cycles, rFSH has a higher potency than uFSH.

Adolescent↗
PubMed1999

Intake of long chain w3 polyunsaturated fatty acids during pregnancy and the influence of levels in the mother on newborn levels.

OBJECTIVE: To assess the relationship between the free intake of long chain w3 polyunsaturated fatty acid (w3 LCP) during pregnancy and the levels in the mother with the levels in the neonate. DESIGN: Cross-sectional study. SETTING: University hospital. SUBJECTS: One hundred and sixty-two mother-neonate pairs from normal at-term pregnancies. MAIN OUTCOME MEASURE: Dietetic interview in order to assess the w3 LCP intake. w3 LCPs were analyzed by capillary gas chromatography in plasma (expressed as percentage and as total amount) and in erythrocyte phospholipids (expressed as percentage) from mothers and neonates. RESULTS: The w3 LCP intake assessed by the dietetic interview was significantly correlated with w3 LCP levels in the plasma of both mothers and neonates. The levels of w3 LCPs in mothers and neonates were significantly correlated both in plasma fatty acids (expressed both as a percentage and absolute values) and in erythrocyte phospholipids (in percentage) (r=0.49-0.22). CONCLUSION: In an apparently well-nourished population the w3 LCP levels of the newborn infants are clearly influenced by those of their mothers. The higher the levels in mothers, the higher those in the neonates. The w3 LCP intake assessed by an interview also showed a significant influence, but to a lesser extent.

Cross-Sectional Studies↗
PubMed1998

Endometriosis and spontaneous abortion rate: a cohort study in infertile women.

OBJECTIVE: To ascertain if there is an association between endometriosis and spontaneous abortion. DESIGN: Prospective cohort study. SETTING: Medical School Hospital. POPULATION: 174 infertile women laparoscopically diagnosed with endometriosis and 174 infertile women in which endometriosis was ruled out by laparoscopy, in the same period of time. MAIN OUTCOME MEASURE: Spontaneous abortion. Non-progressive gestational sac and/or histological study. RESULTS: Per woman abortion rate was 7.47% (13/174) in the endometriosis group, similar to 5.74% (10/174) in the infertile women without endometriosis (RR=1.32: CI=0.53-3.36). Nor were there any differences in the per pregnancy abortion rate: 20.96% (13/62) in endometriosis vs. 16.94% (10/59) in non-endometriosis (RR=1.3; CI=0.47-3.57). The abortion rate was similar in the different AFS stages: 22.86% (8/35) in stage I, 16.67% (3/18) in II, 25% (1/4) in III and 20% (1/5) in IV. In stage I no differences were observed in patients who were managed expectantly or with medical treatment. CONCLUSION: Endometriosis is not associated with an increased abortion rate. The severity of disease expressed by AFS staging is not associated with an increase in the abortion rate. In stage I the treatment of endometriosis did not decrease abortion rates.

Abortion, Spontaneous↗
PubMed1998

Fetal cardiotocography and acid-base status during cesarean section.

OBJECTIVE: To assess the fetal well-being during cesarean section, in relation to the previous fetal condition. DESIGN: Observational study. SETTING: University Hospital. PATIENTS PARTICIPANTS: 204 women undergoing cesarean section (203 intrapartum cesarean sections): 177 with general anesthesia and 27 with spinal anesthesia. MATERIAL AND METHODS: We compared the fetal heart records of the last 30 min before cesarean section (during the first stage of labor) with those during cesarean section. Scalp blood analysis 30 min before the beginning of anesthesia induction was compared with umbilical artery analysis at delivery. MAIN OUTCOME MEASURES: Cardiotocography. Acid-base analysis. Apgar scores. RESULTS: During cesarean section there was a reduction in uterine activity, an increase in silent tracings and a decrease in late decelerations. Umbilical artery pH was lower than scalp pH (7.23+/-0.06 vs 7.30+/-0.06). Oxygen saturation was also lower (14.43+/-8.58% vs 18.99+/-8.4%). The values of pCO2 and of base deficit were higher. During cesarean section low values of modified Fischer scores were associated with low pH values of umbilical artery and low Apgar scores. CONCLUSION: Silent tracings appearing during cesarean section usually do not indicate fetal distress. Poor intracesarean fetal heart tracings were associated with worse indicators of neonatal well-being. Although umbilical pH were lower than scalp values, when the correction described in the literature was applied, the difference was of little clinical relevance. It is concluded that anesthesic, pharmacological and surgical events have slight repercussion in fetal well being. However, in a few cases fetal heart monitoring during cesarean section could detect otherwise undiagnosed cases of transient acidemia or depression in the fetus.

Acid-Base Equilibrium↗
PubMed1998

Neonatal morbidity associated with disproportionate intrauterine growth retardation at term.

We set out to compare neonatal morbidity between disproportionate intrauterine growth retarded newborn infants and proportionate retarded ones at term, based on ponderal index. This is a prospective study of 185 single pregnancies with evidence of intrauterine growth retardation at term. Sixty three cases (34%) were disproportionate and 122 (66%) proportionate in terms of ponderal index. All were born in the University Hospital 'Principe de Asturias' of Alcala de Henares, Madrid, Spain. Proportionate or disproportionate intrauterine growth retardation diagnosis was established using the ponderal index (weight/length3). The following outcomes of neonatal morbidity were investigated: (1) perinatal asphyxia (meconium-stained amniotic fluid, abnormal fetal heart rates, newborn acidosis or low Apgar score 7 at 5 minutes) and/or (2) early neonatal medical complications. Disproportionate intrauterine growth retardated newborn infants presented higher rates of perinatal asphyxia (54% vs. 32%, P 0.01), with higher abnormal fetal heart rates (37% vs. 15%, P 0.01), higher frequency of arterial pH 7.20 (31% vs. 16%, P 0.05); and also higher rates of early neonatal medical complications (40% vs. 11%, P 0.001), mainly hypoglycaemia (25% vs. 4%, P 0.01). Morbidity among disproportionate intrauterine growth retardated Aconates is significantly higher compared with proportionate ones, demonstrating the heterogeneity of the intrauterine growth retardation population. Proportionate and disproportionate intrauterine growth retardation should be diagnosed as early as possible, since the majority of the morbidity is intimately related to this difference.

Journal Article↗